Perioperative prevention of penile prosthesis infection: Practice patterns among surgeons of SMSNA and ISSM Journal Article


Authors: Katz, D. J.; Stember, D. S.; Nelson, C. J.; Mulhall, J. P.
Article Title: Perioperative prevention of penile prosthesis infection: Practice patterns among surgeons of SMSNA and ISSM
Abstract: Introduction. Anecdotally, there is great variation in the use of strategies to prevent postoperative penile implant infection. Aim. To evaluate the perioperative practice patterns of surgeons who insert penile prostheses focusing on their respective infection control routines. Method. An anonymous Web-based survey was sent to members of the Sexual Medicine Society of North America (SMSNA) and the International Society of Sexual Medicine (ISSM). Main Outcome Measures. Thirty-nine questions were asked pertaining to the strategies used during the pre-, intra-, and postoperative phases of penile implant surgery to prevent infection. Results. One hundred twenty-nine surgeons responded to the survey (SMSNA 84; ISSM 45). Most surgeons considered themselves sexual medicine specialists. More SMSNA respondents had inserted >100 prosthesis (SMSNA 69%, ISSM 50%). Routine urine culture is not performed by 40% and 50% of SMSNA and ISSM members, respectively. Similar percentages of surgeons from each society request a daily preoperative antimicrobial scrub. About two-thirds of ISSM members use razors for the preoperative shave compared with one-third of SMSNA members. Most ISSM surgeons preferred povidone-iodine for hand and skin preparation while most SMSNA surgeons chose this only for skin preparation. Two-thirds of SMSNA members prepared the skin for at least 10 minutes compared with 34% of ISSM surgeons. There were considerable differences in all aspects of antibiotic usage not only between members of both societies but also among individual members of each society. Most surgeons prefer not to place a drain (SMSNA 70%, ISSM 81%). Discharge timing differs between the two groups. Conclusions. There is great variation in perioperative strategies utilized to prevent penile implant infections including some key differences between surgeons from SMSNA and ISSM. It is unknown if these variations result in changes in the postoperative infection rate; however, the study data may assist in the formation of practice guidelines and form the basis of future prospective studies. © 2012 International Society for Sexual Medicine.
Keywords: antibiotic agent; postoperative period; preoperative care; outcome assessment; clinical practice; physician's practice patterns; infection; prosthesis-related infections; europe; intraoperative period; urology; surgical drainage; hospital discharge; infection prevention; erectile dysfunction; povidone iodine; infection control; antibiotic prophylaxis; health care surveys; north america; latin america; perioperative care; penis disease; penis prosthesis; urine culture; inflatable penile prosthesis; penile prosthesis; prosthesis infection; antibiotic selection; practice pattern survey; survey of urologists; three-piece penile implant; penile prosthesis infection
Journal Title: Journal of Sexual Medicine
Volume: 9
Issue: 6
ISSN: 1743-6095
Publisher: Elsevier Inc.  
Date Published: 2012-06-01
Start Page: 1705
End Page: 1714
Language: English
DOI: 10.1111/j.1743-6109.2012.02724.x
PROVIDER: scopus
PUBMED: 22510324
DOI/URL:
Notes: --- - "Export Date: 2 July 2012" - "Source: Scopus"
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Darren Jonathan Katz
    43 Katz
  2. John P Mulhall
    601 Mulhall
  3. Doron Sol Stember
    22 Stember
  4. Christian Nelson
    391 Nelson